Abstract
BACKGROUND: Adherence to prescribed offloading among people with diabetes is often insufficient. Although factors influencing adherence with prescribed footwear have been well studied, uncertainties remain. Perceptions and views of people with diabetes on their prescribed foot orthoses, including areas for improvement, may offer important insights. METHODS: Using a qualitative study design, a combination of online focus groups and individual interviews were employed to gain a deeper understanding of the experiences and perceptions of people at risk of diabetes-related foot ulcers regarding experiences of prescribed foot orthoses. All interviews and focus groups were recorded and transcribed verbatim. Transcribed data were coded, and thematic analysis was undertaken following a six-step thematic analysis framework. FINDINGS: Eight people with diabetes at risk of developing foot ulcers who had been prescribed foot orthoses were included. Three major themes emerged from thematic analysis: (i) adherence and barriers to effective use of foot orthoses, which captured the role of health professionals as well as the interconnected relationship between footwear and foot orthoses, (ii) perceived benefits of foot orthoses and desired improvements, and (iii) anxiety and psychological impact, which highlighted how anxiety and fear can influence footcare behaviours, both as motivators and barriers. CONCLUSION: This study provides valuable insights into user experiences of prescribed foot orthoses and factors influencing foot orthoses-related behavioural choices; these findings may help researchers and healthcare professionals in designing and delivering foot orthoses that better meet the needs of users to enhance engagement with preventative strategies. Important considerations include the perception of balance and stability, the psychological impact of diabetes-related foot disease and the role of the healthcare professional in providing support both during and after foot orthoses provision.